Catastrophic Care

How American Health Care Killed My Father--and How We Can Fix It

"A visionary and completely original investigation that will change the way we think about health care: how and why it is failing, why expanding insurance coverage will only make things worse, and how it can be transformed into a transparent, affordable, successful system"--"A visionary and completely original investigation that will change the way we think about health care: how and why it is failing, why expanding insurance coverage will only make things worse, and how it can be transformed into a transparent, affordable, successful system. In 2007, David Goldhill's father died from a series of infections acquired in a well-regarded New York hospital. The bill was for several hundred thousand dollars--and Medicare paid it. These circumstances left Goldhill angry and determined to understand how it was possible that world-class technology and well-trained personnel could result in such simple, inexcusable carelessness--and how a business that failed so miserably could be rewarded with full payment. Catastrophic Care is the eye-opening result. Goldhill explicates a health-care system that now costs nearly $2.5 trillion annually, bars many from treatment, provides inconsistent quality of care, offers negligible customer service, and in which an estimated 200,000 Americans die each year from errors. Above all, he exposes the fundamental fallacy of our entire system--that Medicare and insurance coverage make care cheaper and improve our health--and suggests a comprehensive new approach that could produce better results at more acceptable costs immediately by giving us, the patients, a real role in the process. "--

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Sort of sounds like it is addressing the issues, but without really addressing the issues. A private health insurance situation, predatory capitalism at its worse, must first be addressed to the fullest. The top two cost drivers in the American Healthcare system: [1] hedge fund speculation across the entire spectrum of the healthcare sector, and [2] private equity--leveraged buyouts across the entire spectrum of the healthcare sector. As long as it is a private, capitalistic based system, prices will continue to skyrocket -- the Obama signed legislation (ACA) is the subtle bailout of the health insurance industry, hurting from the massive offshoring of jobs, leading to fewer corporate-purchased health insurance premiums, and so on -- and it was the insurance companies which were among the major offshorers, with Prudential leading the way back in the 1970s, offshoring a tremendous number of jobs to Ireland.

Essential reading for anyone interested in understanding why our health care system is so dysfunctional and how it can be fixed. It's written in clear, non-technical English, and it was a pleasure to follow his lucid presentation. If you think that the Affordable Care Act is going to solve the problem, or that it is going to wreck the system, read this and think again.

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Every business would like to get away with high prices, poor quality, and miserable service, but this behavior carries an unacceptable cost: lost customers, lost revenue, lost profits.

In health care, bad behavior doesn't produce these bad results; bad behavior is often rewarded with additional revenue, and efficiency with less.

At the heart of these perverse incentives is insurance. . . .But not only is insurance the costliest way of financing our spending, it is the most distortive; the insurance model requires that we turn over our role as consumers to what I call the Surrogates: private insurers, Medicare, and Medicaid.

As I'll show, their actions -- and our own absence as a disciplinary force in the health care marketplace -- create many of the incentives for bad behavior.